A Prognostic Model of the Development of Cognitive Impairments in Patients with Type 1 Diabetes Mellitus
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A Prognostic Model of the Development of Cognitive Impairments in Patients with Type 1 Diabetes Mellitus Yu. G. Samoilova,1 M. A. Rotkank,1 D. A. Kudlay,2,3 N. G. Zhukova,1 M. V. Matveeva,1 and I. V. Tolmachev1
Translated from Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova, Vol. 120, No. 3, Iss. 1, pp. 19–22, March, 2020. Original article submitted January 10, 2020. Accepted January 17, 2020. Objective. TO develop a prognostic model of the development of cognitive impairments in patients with type 1 diabetes mellitus using proton magnetic resonance spectroscopy data. Materials and methods. The study included patients with type 1 diabetes mellitus (DM) and people without DM (control group). Carbohydrate metabolism was assessed in all participants, and all underwent neuropsychological testing (using the MoCA test) and proton magnetic resonance spectroscopy of the brain. Results were analyzed statistically in IBM SPSS Statistics 20.0. The prognostic model was computed by discriminant analysis. Results. Proton magnetic resonance spectroscopy data and discriminant analysis yielded a prognostic model for the development of cognitive impairments in patients with type 1 diabetes mellitus. Conclusions. The method developed here for the early diagnosis of cognitive impairments provides early prognostication of the development of cognitive impairments in patients with type 1 diabetes mellitus and can be used in clinical practice to assess the efficacy of treatment used for the prophylaxis of cognitive impairment. Keywords: cognitive impairments, diabetes mellitus, magnetic resonance spectroscopy, prognostic model.
Diabetes mellitus (DM) is a metabolic disorder with multifactorial adverse effects on various tissues and organs [1], at the same time being an important risk factor for the development of cognitive impairments [2–4], and the problem in diagnosing these occupies one of the central positions in current neurology. There is a significant gap in the diagnostic criteria, filling of which would allow accurate location of the pathological focus leading to changes in the cognitive domain and selection of personalized treatment for each individual patient depending on the pathology identified. The development of imaging-based diagnostic methods have led to the employment of a whole range of magnetic resonance investigation methods, including proton magnetic resonance spectroscopy, which provides assessment of
the metabolic composition of various tissues, with determination of the contents of the main metabolites responsible for the structural and functional integrity of cells [5]. Proton magnetic resonance spectroscopy of brain tissues provides the opportunity to diagnose metabolic disorders which may cause cognitive deficit in patients with type 1 DM [6–9]. However, the literature lacks fundamental grounds for the use of this method in patients with DM and there are as yet no clear diagnostic criteria for cognitive impairments. The aim of the present work was to develop a prognostic model for the development of c
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